NPIMap

Individual provider Active NPI

Mohammad Reza Rahnama, MD

  • Internal Medicine Physician
  • Parkville, MD
National Provider Identifier
1952458739
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0045475 Issued in MD
Practice address
9512 Harford Rd Ste 4
Parkville, MD 21234-3127
Phone
(410) 665-4400
Fax
(410) 661-2420
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0045475 MD Primary

Addresses

Primary practice location

9512 Harford Rd Ste 4
Parkville, MD 21234-3127

Mailing address

9512 Harford Rd
Suite 4
Parkville, MD 21234-3100
Phone (410) 665-4400

Other identifiers 5

IdentifierTypeStateIssuer
E268-0002OtherMDFEDERAL BLUE SHIELD
110118499OtherMDMEDICARE RAILROAD
371241900MedicaidMD
53440804OtherMDBLUE SHEILD OF MD
552987OtherMDAETNA PLANS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091118000018 MD Practitioner - Internal Medicine 3678611688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9512 Harford Rd
Suite 4
Baltimore, MD 21234-3127
Phone (410) 665-4400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0045475MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TCMG PA Internal Medicine CurrentSince Sep 1, 1995 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

19 Fontana Ln
Ste 102
Baltimore, MD 21237
Phone (410) 780-0630

6730 Holabird Ave
Dundalk, MD 21222
Phone (410) 288-5220

9512 Harford Rd
Ste 4
Parkville, MD 21234
Phone (410) 665-4400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1952458739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9512 HARFORD RD",
            "address_2": "SUITE 4",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212343100",
            "telephone_number": "410-665-4400",
            "fax_number": "410-661-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9512 HARFORD RD STE 4",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212343127",
            "telephone_number": "410-665-4400",
            "fax_number": "410-661-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHNAMA",
        "first_name": "MOHAMMAD",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0045475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLUE SHIELD",
            "identifier": "E268-0002",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110118499",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371241900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD OF MD",
            "identifier": "53440804",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PLANS",
            "identifier": "552987",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkville, MD

Sources for this page

Verify at the official NPI Registry.